FeaturedApplying for Medical Assistance

 Help Sheet for Applying for Medical Assistance

January 2017

Please note that I am writing this to you as a guide to assist you. I have had many family members voice frustration with me as to the “how’s” of navigating through the medical assistance application process. I am not an attorney, and this is not legal advice but rather things I have learned over the past 25 years of helping families through the process.

We accept the GRH, Group Residential Housing rent rate which the State of MN determines every summer, for a shared companion room. This means that you can only remain in a private room while on medical assistance, if someone other than the person applying for medical assistance chooses to pay the private room differential for the resident.

  1. When should you apply for Medical Assistance, which is generally titled elderly waiver (EW) in assisted living settings?
    1. A good rule of thumb is to call the county phone numbers in the county which you reside 60 days before your assets reach $3,000 as a total balance.
    2. If you do not have care needs as determined by the state, you may be denied access to assisted living, if your needs could be met in another independent setting. The nurse who determines your level of care needs determines this on the LTCC Consultation or MN Choice Assessment. The State of MN wants to make sure seniors are placed in settings which meets their needs.
    3. You can access the medical assistance application through this link: https://edocs.dhs.state.mn.us/lfserver/Public/DHS-5223-ENG. 
  1. There are two very important steps to make: (1) is to apply for financial assistance and fill out the medical assistance application and call the county financial worker (2) is to call for a LTCC or MN Choice level of care assessment with the county.
    1. The financial eligibility is one aspect of the process, which determines financial need after the county reviews the application completed by the resident/family member. Once the financial edibility is started with the case has to be opened in 60 days, otherwise if paperwork is not completed, the case will go back to day zero and the process for opening medical assistance may be delayed and the resident may have no payer source to pay their bills for care in a setting such as assisted living.
    2. The level of care assessment is something that is a second aspect of the process, and this is done by a separate agency in the county. This level of care assessment determines medical need and is called a LTCC assessment of MN Choice assessment. Once the nurses from the county do the level of care assessment, this is good for only 60 days. This means that the financial team must have all the paperwork they need timely to assure the case is opened for the senior applying for medical assistance.
    3. Once the financial team opens the case, and the nurse determines level of care need to support assisted living need, then the provider can bill the State of MN for the service portion of the cares. It is important to know that the state does not allow back billing, therefore the resident is considered private pay until the county opens the medical assistance case.
    4. Important phone numbers to call for the county you reside in: 
  1. For Diamond Willow Residents who reside in Lester Park, Proctor, Mountain Iron and Keystone Bluffs Residents they should call 218-733-2725 to apply for financial assistance. Please call 218-726-2366 for a LTCC/MN Choice level of care assessment.
  2.  For Diamond Willow Residents who reside in Little Falls, they should call Morrison County at 320-631-3577 and ask for the long term team to assist them with the financial application. Then they should call 320-632-6664 which is public health for the MN Choice application.
  3.  For Diamond Willow residents who reside in Alexandria, they should call Douglas County at 320-762-2302, and this is the number to call to apply for medical assistance. Then call 320-763-6018 and this is public health nurse line to request a level of care assessment which is known as a LTCC consultation or MN Choices.
  4.  For Diamond Willow residents who reside in Detroit Lakes, they should call Becker County at 218-847-5628, and press zero and ask for: The adult service intake team who processes the LTCC Long Term Care Consultation which is known as the MN Choices and this determines level of care need. Then you will need to call back the same number at 218-847-5628, and press zero and ask for the financial team to apply for medical assistance in assisted living.
  5. For Diamond Willow residents in Baxter, they should call Crow Wing County at 218-824-1250, and when they answer it will say Crow Wing County Economic Assistance line. Then there will be a menu of seven choices. Press, number 0 to speak to a county representative. Then it will say to list to four more choices, then press 4 to speak to a county representative. Please let them know you need to apply for medical assistance and you reside in assisted living. Then call 218-824-1140 to schedule a LTCC screen/MN choice assessment which determines the level of care need.
  6. For Diamond Willow residents in Grand Rapids, they should call Itasca County at 218-327-6706 or 218-327-6146 and let them know you need to apply for financial assistance and you reside in assisted living. You also need to let them know you need a LTCC/MN Choice screen from a nurse to determine the level of care need of the person who is applying. 
  7. For Diamond Willow residents in Park Rapids, they should call Hubbard County at 218-732-2453 and let them know you need to apply for financial assistance and you reside in assisted living. You also need to let them know you need a LTCC/MN Choice screen from a nurse to determine the level of care need of the person who is applying.
  1. Other things to be aware of:
    1. It is important to know that your monthly income is a completely separate thing from your total assets when applying for medical assistance. Therefore, assets can be a variety of items such as savings, checking, stocks, bonds, commercial or residential property, land etc. as just a list of some common examples.
    2. If you are a married couple, the county will do an assessment to determine your eligibility and sometimes one person remains in their home and one person needs a higher level of care. Sometimes both people need a higher level of care and the county has a formula for this which the state has set forth.
    3. The look back period is 60 months before the date of applying for medical assistance (elderly waiver), therefore if assets are transferred outside of this time period there may be a disqualification period to match the amount of money transferred. This is something the county would determine when doing the application for medical assistance.
    4. Have you had a Long term Care Consultation? This is what is also referred to as MN choices which determine that the applicant has care needs which the assisted living provider offers.
    5. If the county determines you have a high monthly income as defined by the State of Minnesota, you may have what is called a “Spenddown or waiver obligation”. What this really means is that in addition to the amount you pay for your rent, which is currently $891 per month for a shared room when on medical assistance, then you are personally responsible to pay an additional amount of money from your monthly income to the provider monthly. This is what “spenddown or waiver obligation means”. If you have a spenddown or waiver obligation, the state reduces the amount they pay the provider for the services, because the resident has a high monthly income and can afford to pay a higher portion.
    6. During the time you are applying for medical assistance, the resident is responsible to continue paying the provider monthly to avoid an eviction notice. All residents are considered private pay until they are opened on medical assistance.

 4. Some items to gather early for records the state will want to review

  1. Recent bank statements of balances
  2. Real estate property tax statements, and documents showing amount owed against property
  3. Burial contracts and the name of the company or funeral home that holds the contract
  4. Other assets such as bonds, trust, stock ownership, annuities, etc. and you must have the current statement with any balance owing against asset.
  5. Other

Transforming To A New Life


Embarking on a new journey

As you grow older, you may be fit as a fiddle or may require some assistance with little reminders, while some might need even more support and assistance. Words like assisted living, retirement home and hospitals come to mind, and a certain sense of dread and guilt. However, there is nothing wrong for families and the elderly to search for assisted living homes and pick the one they would feel safe and comfortable in DuLuth, MN. All of us deserve to live a comfortable and fulfilling life, and assisted living allows the elderly to live in a healthy, supportive, and supervised environment.

Getting Started

They could make informed inquiries about assisted living homes and visit the place to be sure it is just the right place for you. Usually, people who come and stay in assisted living homes are quite fit but need some amount of care, like taking medicines, doing laundry, and changing clothes.Others might just need reminders and assistance . Of course, money plays a role in the kind of services you will be offered. So, start saving and be exactly sure of what are your needs and requirements before choosing a certain package.

Taking care of your essential needs

How much thought have you given to thinking of the kind of assisted living facilities you will need?What will be provided by the assisted living home you choose in Duluth, Minnesota? If you have, or currently are thinking along these lines, then you are on the right track.  Additionally, do your research, ask the members residing in the assisted living home and interview the staff members and make your observations while you visit the assisted living home at Duluth, MN.

Facilities, Festivities, and Healthy Activities

Established assisted living homes provide facilities like bus tour to the grocery stores, parks, restaurants or any other place you would like to go. Birthdays and other events are also celebrated, in addition to musical shows, card games, dancing sessions, cooking classes and many more are also planned. As for the services, a calm serene environment, cable TV, home cooked meals, laundry, transportation, personal care attendants, and 24-hours nurses on site add to the comfort. All these and many more are provided depending upon the payment and the kind of package of services you choose. So,choose and spend wisely on assisted living facilities.

Looking for an apartment

Senior apartments are not that easy to find if you are looking for it in a certain budget. Hiring a real estate agent or searching online at Duluth, Minnesota for senior apartments. Well you will have to make a lot of calls, take a lot of visits, discuss with veterans who are already living in senior apartments and consult with other senior citizen members too.The place should feel like a community where you belong, it should match with your personality and lifestyle and of course have the proper environment and facilities you will require. Senior apartments at Duluth, MN have some wonderful landscapes and views available at senior apartments.

The right to choose your lifestyle

Independent senior living is a lifestyle choice. If you feel you have taken good enough care and are capable— physically, financially and emotionally— then go for it. There are plenty of assisted living home and apartments in the community of Duluth, MN for independent senior living.

Living in senior apartment is also a form of independent senior living. You can live in retirement communities, congregate housing, manufactured housing and senior apartments. All of them provide independent senior living.The kind of living you will choose will reflect your personality and also your needs. For example, congregate housing can provide facilities depending on what kind of area and price value has been paid. Additionally, manufactured homes are designed specifically for a certain senior citizen according to their comfort and needs. Choose the one that is near your family in Duluth, MN as it will give them and you a chance to visit each other.

Recovering from an ailment

There are plenty of convalescent homes at Duluth, Minnesota for our elderly members. As you grow older, you are more likely to fall and get injured or need some kind of surgery or suffer from diseases that come with old age. Initially, you are kept at convalescent home to recuperate . This provides youa separate place with specialized nurses attending to you 24/7with your family members visiting you. Once you recover you are free to leave the Convalescent home at go back to your senior independent living at Duluth,MN.

As you turn over a new leaf and look for assisted living home, senior apartments, senior independent living or other retirement communities go visit keystone bluffs website  https://keystonebluffs.com/.

Senior Apartments: Do You Qualify?

Looking around for senior living options? You have a number of choices: senior apartments, nursing care homes and assisted living facilities in Duluth, MN. Which one of these should you go for? The answer primarily depends on your current health and the level of assistance that you require. For those who want some degree of independence yet be surrounded by other elderly people, senior housing or senior apartments in Duluth, MN is a good option.

The term senior housing is differentiated legally. You should be able to understand what sets it apart from other senior living options in Duluth, MN. Senior housing refers to properties that are exempted from the Fair Housing Act’s ban on familial status discrimination; the term caters to people beyond a certain age, and in a specific way. FHA codes that the term senior housing applies to the following communities or units.

  • 62 years or older – The age of occupants is 62 or more
  • 55 or older – One of the occupants’ age should be 55 or more; such occupants should reside in 80% of occupied units, and the community should adhere to policies that allow housing people whose age is 55 or more.
  • Government program – HUD has classified some dwellings specifically for older people under a local, state or federal program

Typically, a landlord can’t refuse tenants based on their familial status or if they have children below 18 years. But, if their properties qualify for senior housing, then the landlord has a legal right to discriminate families who have children.

Senior housing is different from assisted living in Duluth, MN, so don’t get confused between the two. An assisted living facility can be termed as senior housing if it qualifies, but senior housing does not have to offer special services for physically disabled beings.

That being said, senior housing is for people over a certain age. Here are some points worth highlighting.

You don’t have to be that old

As per the rules, anyone who is 55 or over can live in senior apartments in Duluth, MN, if certain conditions are met. Fact is that even if you are less than 55, you can still live in a senior house if your spouse or someone else in the family is 55 years old. If none of your family crosses this threshold, then also you can consider living in that 20% people for whom there aren’t any restrictions.

You are considering 62 and older senior apartments in Duluth, MN

If you are thinking about living in housing that caters to 62 years and older citizens, then everyone in your family must meet this age limit. The only exception is a nurse, attendant or another caretaker living in your household.

You can ask for reasonable changes

Wherever you choose to live, landlords are required to make modifications if it caters to your disabilities.

You have to prove your age

You have to show a proof of your age when you apply for a senior housing option. This can be your passport, birth certificate, driving license or another documentation.

Can Younger People Opt for Assisted Living

Assisted living institutions are quite synonymous with the old and the frail. However, little do people know that assisted living programs are also available to troubled young adults who may be in need of a safe and supportive environment as they further transition into their adult life.

Following are some of the many reasons why young people can also opt for assisted living:

  • There are times when parents are struggling with their children and are in need of desperate help. They can seek for a transitional living program, offered by assisted living institutions, which can effectively teach their young kids to be independent, confident and stable while at the same time equip themselves with a better coping mechanism.

 

  • If you have a loved one who is suffering from disorders like Autism, Asperser’s or some other form of mental illness, then an assisted living institution can help you in this regard. There are programs specifically designed for young adults with similar disabilities to learn how to better manage their lifestyle and effectively communicate with those around them.

 

  • Young people who are physically challenged or are a victim of substance abuse often struggle in their lives facing exclusion from society and social interactions. Assisted living communities provide them an opportunity to socialize with people facing similar conditions and explore new ways to better understand their conditions. They also require added supervision and monitoring in their daily activities by experienced professionals.

 

  • Some young adults are dependent on constant supervised medical treatments and require frequent medical attention for their developmental needs. Assisted living centers offer accommodation to such individuals for a better suited lifestyle where they can get easy access to all their medications and better health care.

Why You Should Consider Shifting Your Loved One to a Nursing Home

Your loved one’s declining health due to old age can be difficult to cope with. As the roles of caregivers shift, it is your duty to ensure your elderly loved ones are well cared for and comfortable in the future. However, the thought of shifting your loved ones to a nursing home can inspire feelings of guilt and betrayal. In these situations, it is important you are able to identify their health care needs so you can make an informed decision. Here are a few reasons why you should consider shifting your loved one to a nursing home:

Growing Health Care Needs

Understand that caring for the elderly may initially seem manageable but as their condition grows worse, you may not be able to decide what’s best for them. Health conditions, such as dementia, can grow worse without proper supervision, resulting in major health risks to an elderly person. By choosing to act as a caregiver, you may not always be prepared for the demands of managing hospital appointments, keeping track of doctors and supervising medication intake.

A nursing home offers around the clock services along with a professional and trained staff that will be prepared to cater the needs of your loved one.

Providing Your Loved Ones the Care and Attention They Need

Due to personal obligations, kids and managing household duties, you might not be able to provide your elderly parents the time and attention they need. The role of a full-time caregiver can be quite overwhelming if you are not prepared to make sacrifices. Opting for a cozy nursing home for your loved one where you can play an active role may be the best option if you cannot juggle your personal obligations.

Sending your loved one to a nursing home may be beneficial for their overall heath, especially if you won’t be able to play the role of a full-time caregiver.

Understanding the Assisted Living Pricing Model

Assisted living refers to a housing facility for people who are disabled or adults who cannot live independently. This is obviously not a matter for choice but due to some reasons, they have to live at a place where someone can look after their basic needs. Usually, these are related to their health problems. There are different pricing models that are used at such facilities. It’s important to understand these models.

All-inclusive

An all-inclusive facility, as its name suggests, includes everything the person uses including room, healthcare, security and transportation. The cost remains the same for every month. In this regard, if there are any changes in needs, there has to be no change in the level of pricing. However, this is an expensive option to consider.

Fees per Service

This service only includes the costs of the facilities that are used by the person depending on his or her needs excluding rent and food. This is beneficial for people who can pay for their transportation and other costs on their own. There is no doubt this pricing model leads to a more affordable service for people seeking assisted living.

Low Income Options

There are low-income facilities available as well for those who cannot afford to pay high costs. For this, they have to contact the government and are referred to a suitable facility. There are government budgets for this as well so it is easy for everyone to use these facilities.

All the costs must be checked before the admission of a person and check whether the person can afford it or not. This must be checked by the loved ones of that person to avoid any confusion afterwards. This is the key to avoid any emotional tragedy for that individual and the person may have to leave immediately.

Why You Should Involve Your Senior Loved One’s Doctor When Deciding on Assisted Living

Assisted living facilities offer senior residents with a housing alternative and help with daily life tasks, such as bathing, dressing, toileting, and eating. In addition, these facilities also provide a wide range of services and activities, such as sports, educational workshops, field trips and fitness classes. If you are searching for the right assisted living facility, here are some of the factors you need to keep in mind:

  • The ability of the staff to efficiently care for the residents
  • The reputation of the facility
  • Location, and the distance from your home
  • The building’s general cleanliness and sanitary level
  • Your financial capability
  • The quality of lifestyle offered. This includes food, water, lighting, air and other recreational services.

Another important consideration many people overlook is seeking the opinion of their senior loved one’s doctor when deciding on the right assisted living facility. Getting a word of advice and discussing the situation with a doctor brings a number of benefits. First, general physicians and doctors have connections with various care facilities, and will therefore be able to guide you regarding the best facilities with suitable care plans and affordable prices.

A doctor who has been handling your senior loved one for quite some time now will have a good insight into any present physical or mental problems he/she may be suffering from, and will help you choose a facility that specializes in dealing with that particular problem. For instance, some assisted living facilities may cater to residents with anxiety or stress.

Lastly, a doctor can give you valuable word of advice in terms of the entire payment process, and guide you through tricky aspects, like insurance, private payment, Medicaid and Medicare.

For all these reasons, it is best you involve a doctor when choosing the best assisted living facility for your senior loved one.

Is Assisted Living the Right Choice for Your Senior Loved One?

If your loved one can no longer live alone without risk to his/her health or safety, it is time you help them get the care they deserve. Assisted living facilities specialize in providing professional assistance to senior citizens while allowing them some level of independence. But is the right choice for your loved one?

When weighing the pros and cons of sending a senior family member to a facility, ask yourself the following questions that will help determine whether you are making the right choice or not.

  • Is your loved one fine on their own? Living alone in a home is not only expensive but its maintenance calls for extra effort. Raking leaves in the fall, shoveling snow in the winter, keeping an eye on the housekeeper and carrying out daily chores may too much of work. If your loved one is not in a position to handle all the work alone (even with the help of a caretaker), assisted living might just be the right choice.
  • Are you fine with taking care of them? Especially if you have a family of your own, giving constant attention and care to an old family member can become expensive and difficult after some time. If you find yourself struggling to look after them, it is best to leave them in the care of professionals.
  • Is your loved active and interactive? A passively inactive senior loved one is more likely to feel bored, anxious and depressed. So, unless they are involved in social gatherings and interactions frequently, sending them to an assisted living facility will be a better way to go. This is because these care centers make sure residents get plenty of physical and mental exercise through various classes, activities and organized group fieldtrips.

Answering these questions will help you determine if assisted living is the right choice for your senior loved one or not.

Importance of Avoiding Crisis-Based Decisions Regarding Assisted Living

Whether it is a fall, death of a spouse, or loss of a reliable caregiver, many families find themselves making assisted living decisions in “crisis mode”. Although this decision can prove life changing for some, others may simply come to regret it in the end. To save yourself the added stress and hassle, here are a couple of ways in which you can avoid crisis-based assisted living decisions:

Discuss with Family Members in Advance

A family who takes action only when faced with crisis usually finds itself making decisions it will soon come to regret. So, it is better that you handle matters farsightedly and encourage family members to voice their wishes and concerns, along with important legal, financial and medical records, beforehand. For a decision to be beneficial, it is important that all family members should be involved in it equally.

Start Asking for Recommendations

Ask your friends, neighbors and physicians for recommendations. Browse the internet, schedule appointments and visit assisted living facilities personally. Take along your family members too so everyone can have a say in the matter.

The Importance of Avoiding Crisis-Based Decisions

Making decisions, especially those that affect your health and safety, require sufficient time for thorough research and the decision-making process itself. Most crises leave you mentally scarred, and therefore you may not be able to choose as wisely as you can otherwise. Furthermore, there is a chance that you may be exploited by a facility if it detects urgency in the situation, resulting in you either paying more or settling for something mediocre.

It is therefore important that you either decide such critical matters in advance or wait till the crisis is under control. This way, you will be more likely to make a decision that will benefit you in the long run and therefore, be able to get the best care for your senior loved one.

How to Compare Assisted Living Facilities

If your senior loved one is facing trouble with their daily tasks, like dressing, showering, running errands and getting around the house, the answer may lie in an assisted living facility. These facilities provide their members with all the daily needed support as well as independence so that an optimum level of contentedness can be maintained. Leaving your home, the memories and the people behind can be difficult, but when you make a decision that precisely addresses the needs and concerns of you or your senior loved one, you are ultimately making sure that the years spent ahead are happy.

When considering a shift to an assisted living facility, a thorough comparison between different facilities is important that will help you make the right decision. Nevertheless, this part is overwhelming and time-consuming, especially if you do not know where to start. Following are the three key areas that you need to take into account when comparing assisted living facilities:

Cost

It is important to note that that different facilities have different pricing structures, which can vary from a daily to a monthly rate. Furthermore, the features included in the pricing may also vary from one facility to another. It is therefore extremely important to have a thorough understanding of what is and isn’t included in the basic price since many assisted living facilities offer different levels of care or tiered pricing.

Licensure

Depending on the needs of your senior loved one, you will need to determine the type of license that will be best suited to meet your needs. Examples of licensure include Extended Congregate Care and Limited Nursing services.

Lifestyle Amenities

Staying active and healthy is extremely important, and therefore you need to ensure whether the facility of your interest is offering recreational programs, such as educational classes, field trips, fitness sessions, sports, arts and crafts.

Keeping these three points in mind will help you decide whether a facility is right for you or not.

Why You Should Consult an Assisted Living Advisor

Watching our loved ones get old is difficult. You know that they are no longer able to live on their own, yet you don’t want their happiness sacrificed or their independence lost. Instead of living in denial, be aware. Although navigating assisted living facilities can be a frustrating and emotional, there are a number of resources you can find information from. On top of that, you also have assisted living advisors who can make the entire process much easier and in precise accordance with your needs.

Why Consult an Assisted Living Advisor

Listed below are 4 reasons why you should involve a professional when making this major decision:

1.     You Are Emotionally Frustrated

Deciding to send off your loved one in the care of a third party is never an easy decision. It is no surprise that people tend to not make their best decisions when overwhelmed or under emotional stress, and that is why you need someone professional to do it for you (or at least help you decide better).

2.     Advisors Know All the Local Facilities

Most assisted living advisors focus on a specific area and are therefore more aware of the ins and outs of the locality. They visit communities on a regular basis and have been working with numerous families with a similar situation as yours, and so can be a great source of information and guidance.

3.     Save Time

Instead of going through a big list of facilities yourself, an advisor can provide you with a detailed list of appropriate options, and can explain you the benefits and special features of each community.

4.     Personalized Assistance

You can tell the advisor exactly what you are looking for and they will create for you a list of communities solely based on your criteria. They will also guide you throughout the process and keep in touch.

So, as you can see, consulting an assisted living advisor can offer a number of benefits and help you make the best possible decision!

 


Keystone Bluffs
Independent & Assisted
Living Apartments
2528 Trinity Road
Duluth, Minnesota 55811
218-727-2800